Chronic otitis media (COM) is an inammatory process in the middle-ear space that results in long term, or permanent changes in the tympanic membrane including atelectasis, perforation, tympanosclerosis, retraction pocket development, or cholesteatoma [1]. COM is a major cause of acquired hearing impairment especially in developing countries.1 According to WHO, prevalence rate of COM in India accounts for 7.8% which is high.2 Perforation in tympanic membrane leads to hearing loss and recurrent ear infections. Persistent perforations occur either due to improper treatment of recurrent otitis media or infected traumatic perforation. Primary goal of treatment for COM (mucosal) is elimination of the chronic inammatory process. The secondary goal is reconstruction of sound conducting mechanism [10]. Tympanoplasty is a procedure to eradicate disease in the middle ear to reconstruct hearing mechanism with or without tympanic membrane grafting [2]. Various types of graft materials including temporalis fascia, cartilage, perichondrium, periosteum, vein, fat or skin have been used in the reconstruction of tympanic membrane (TM) perforation. Although temporalis fascia ensures good hearing is restored, there are signicant concerns that its dimensional stability characteristics may lead to residual perforation, especially where large TM perforations are involved. The “palisade cartilage” and “cartilage island” techniques have been stated to increase the strength and stability of a tympanic graft, but they may result in a less functional outcome in terms of restoring hearing[3]. Smoking habits, the size and site of a perforation, the expertise level of the operating surgeon, age, gender, the status of the middle ear mucosa and the presence of myringosclerosis or tympanosclerosis are all important in determining how successful a graft is[4].

Mucormycosis, also known as black fungus, is a rare but serious fungal infection that has been increasingly reported in patients with COVID-19. This infection typically affects the sinuses, but can also spread to the brain, lungs, and other parts of the body. Risk factors for mucormycosis include uncontrolled diabetes, immunosuppression, and prolonged use of steroids. Patients with COVID-19 who have been hospitalized and on mechanical ventilation, as well as those who have received high doses of steroids, are particularly vulnerable to this infection. Symptoms of mucormycosis include severe headache, facial pain or swelling, black discharge from the nose, and difficulty breathing. If left untreated, the infection can lead to blindness, brain damage, and even death. Early diagnosis and prompt treatment are crucial for managing mucormycosis in patients with COVID-19. Treatment typically involves a combination of antifungal medications and surgical debridement of infected tissue. It is important for healthcare providers to be aware of the potential for mucormycosis in patients with COVID-19, particularly those who have risk factors or are experiencing severe symptoms. Maintaining good glycemic control and avoiding unnecessary use of steroids in COVID-19 patients may also help to reduce the risk of mucormycosis. Aim and Objective: 1. To provide a comprehensive overview of the clinical presentation, symptomatology, pathological, and radiological findings in cases of mucormycosis. 2. To examine the role of various risk factors in the development and progression of Post-COVID-19 mucormycosis and to use these findings to design a customized treatment strategy. Methods: A prospective longitudinal study was conducted at our tertiary healthcare center in Maharashtra. Participants were selected based on the presence of clinical symptoms of mucormycosis and COVID-19 recovery. A comprehensive medical examination was performed, including otorhinolaryngologic (DNE, KOH, Fungal Culture), medical, and ophthalmological evaluations, as well as laboratory tests, biopsy, and imaging studies. The treatment strategy included administration of IV antifungals (Liposomal-Amphotericin B) and surgical procedures such as Modified Denker's approach, open maxillectomy, and orbital exenteration if needed.The patients were followed up for six months to monitor for recurrence.

The incidence of an accessory maxillary ostium (AMO) varies depending on the population and the method used to detect it. In general, AMOs are considered to be relatively rare, with an incidence of 1-2% in the general population. However, the incidence may be higher in certain groups, such as patients with chronic sinusitis or polyposis. The degree of association between Rhinosinusitis and presence of accessory maxillary ostium is still a point of debate. It can vary depending on the population being studied and the method of diagnosis. Some studies have found a prevalence of accessory maxillary ostium varies from 2-25%, while others have reported rates as high as 44%. Factors such as genetics, race, and sex may also play a role in the development of an accessory maxillary ostium. It is not clear whether maxillary accessory ostia are congenital or acquired. Some studies claim that they develop following maxillary sinusitis. Aim and Objective:To determine the incidence of accessory maxillary ostia in patients of rhinosinusitis. To determine the correlation of accessory maxillary ostia and rhinosinusitis.Methods: A total of 100 consecutive diagnosed patients of Chronic Rhinosinusitis attending E.N.T OPD were enrolled in the study and the correlation between accessory maxillary ostium and rhinosinusitis is assessed.Results: Most common presenting symptoms were nasal obstruction (83%) while anosmia (9%) was the least common. The other complaints were repeated rhinitis (79%), post nasal drip (75%), nasal discharge (73%), headaches (69%) and facial pain (41). 20% of those patients with chronic rhinosinusitis (CRS) had an accessory maxillary ostium (p < 0.001). Conclusion:To conclude, from our study we can say that patients with chronic rhinosinusitis (Both CRSwNP and CRSsNP) had higher incidence of an accessory maxillary ostium. Presence of accessory maxillary ostium (AMO) requires it's meticulous removal.